By Christopher Lee
Washington Post Staff Writer

Americans have a harder time than residents of several other countries getting after-hours appointments with a nurse or primary care physician without going to an emergency room, a study released yesterday found.

Forty percent of U.S. primary care doctors said they had arrangements for after-hours care, according to the survey of more than 6,000 physicians in seven countries. That compared with 95 percent in the Netherlands, 90 percent in New Zealand, 87 percent in the United Kingdom, 76 percent in Germany and 47 percent in Canada.